论文部分内容阅读
目的:观察大鼠急性心肌梗死(acute myocardial infarction,AMI)后左心室心肌重构分析和非梗死区Ⅰ、Ⅲ型胶原含量的变化,分别使用螺内酯和氯沙坦以及将两药合用对AMI模型进行干预,探索醛固酮受体拮抗剂和血管紧张素受体阻断剂对AMI后心室重构和胶原增生的影响。方法:将50只雌性SD大鼠随机分为AMI组、螺内酯组、氯沙坦组、联合用药组和假手术组,每组10只,结扎大鼠左前降支建立急性心肌梗死模型。术后8周进行血流动力学测定、病理分析和非梗死区Ⅰ、Ⅲ型胶原含量的测定。结果:AMI组与假手术组相比,左心室舒张末压(LVEDP)、容积、重量和非梗死区Ⅰ、Ⅲ型胶原含量均显著增加(P<0.05);左心室球形指数、左心室内压最大上升和下降速率(±dp/dt/LVSP)均显著降低(P<0.05)。螺内酯组与AMI组相比,左心室非梗死区Ⅰ、Ⅲ型胶原含量显著减少(P<0.05),其余各指标差异无统计学意义(P>0.05)。氯沙坦组和联合用药组与AMI组相比,LVEDP、左心室实际重量显著降低(P<0.05);左心室容积仅联合用药组有显著降低(P<0.05);而两组的±dp/dt/LVSP显著增加(P<0.05)。螺内酯、氯沙坦和联合用药3组与AMI组相比,左心室非梗死区Ⅰ、Ⅲ型胶原含量均显著减少(P<0.05);且3组之间差异无统计学意义(P>0.05)。结论:螺内酯能有效抑制AMI左心室非梗死区Ⅰ、Ⅲ型胶原的增生,提示螺内酯可能有改善左心室重构的潜在作用。氯沙坦与螺内酯合用可更有效防治AMI后左心室重构,改善左心室舒张功能。
OBJECTIVE: To observe the myocardial remodeling of left ventricular after acute myocardial infarction (AMI) and the changes of type I and type III collagen in non-infarcted area. Spironolactone and losartan, respectively, To explore the effects of aldosterone receptor antagonists and angiotensin receptor blockers on ventricular remodeling and collagen hyperplasia after AMI. Methods: 50 female Sprague-Dawley rats were randomly divided into AMI group, spironolactone group, losartan group, combination group and sham operation group, 10 rats in each group. The left anterior descending branch was ligated to establish acute myocardial infarction model. After 8 weeks, hemodynamics, pathological analysis and determination of collagen type Ⅰ and Ⅲ in non-infarct area were performed. Results: Compared with the sham-operation group, the levels of LVEDP, volume, weight and non-infarct area collagen Ⅰ and Ⅲ in AMI group were significantly increased (P <0.05); the left ventricular spherical index, left ventricular The maximum pressure rise and fall rates (± dp / dt / LVSP) were significantly lower (P <0.05). Compared with AMI group, the content of type I and type III collagen in non-infarcted area of left ventricle decreased significantly (P <0.05), but there was no significant difference between other groups (P> 0.05). Compared with AMI group, LVEDP and LVEDP decreased significantly in losartan group and combination group (P <0.05), while left ventricular volume decreased significantly (P <0.05), but ± dp / dt / LVSP increased significantly (P <0.05). Compared with AMI group, the content of type I and type III collagen in non-infarcted area of left ventricle decreased significantly (P <0.05), and there was no significant difference between the three groups (P> 0.05 ). CONCLUSION: Spironolactone can effectively inhibit the proliferation of type Ⅰ and type Ⅲ collagen in AMI non-infarcted area, suggesting that spironolactone might improve the potential of left ventricular remodeling. Losartan and spironolactone combination can be more effective prevention and treatment of left ventricular remodeling after AMI, improve left ventricular diastolic function.